Text

theses

There is extensive literature in the fields of psychiatry and clinical phenomenology documenting a set of sub-psychotic, sometimes subtle, subjective phenomena prominent in the phenomenology of schizophrenia-spectrum disorders. These phenomena are observed to occur pre- and post-psychosis, predict future psychosis of at-risk individuals, and are believed by some to characterize the very essence of schizophrenia. One such conception of these phenomena is called Self-Disorder, and more specifically disturbances in the subjective experience of self, referred to as “Anomalous Self Experience.” A semi-structured interview emphasizing such anomalies called the “Examination of Anomalous Self Experience” (EASE) was published in 2005 and has demonstrated that it can discriminate disorders on the schizophrenia spectrum from affective psychosis and groups of non-schizophrenia-spectrum disorders, and has high interrater reliability. The potential utility of analogous measures focusing on experiences of the world rather than the self has yet to be assessed. A novel measure called the “Examination of Anomalous World Experience” (EAWE), composed in a format similar to the EASE, has however been created and is under development (under the leadership of Louis Sass). The purpose of this study was to field test the EAWE as a cohesive measure, including an analysis of interrater reliability, on a sample of psychiatric patients and non-psychiatric controls. Initial analysis suggests good interrater reliability and strong specificity to diagnosis but (like many well-studied psychological and neurocognitive constructs) only modest sensitivity to the schizophrenia spectrum. The data also lend preliminary support to the EAWE’s ability to discriminate severe affective disorders from schizophrenia-spectrum disorders and non-psychiatric controls, suggesting potential for use of the EAWE in future research to clarify affinities and discrepancies between the phenomenal gestalt of schizophrenia spectrum and non-schizophrenia spectrum disorders. A potential sample bias toward chronically ill, lower functioning individuals may have diminished the sensitivity of the EAWE. It is possible that the recent experiences of such individuals (in comparison with that of the younger and more recent-onset patients targeted in past EASE research) are less complex in nature, or that, in general, they have less ability to recall or willingness to describe recent or earlier forms of anomalous experience.

ETD_5095

Psy.D.

Includes bibliographical references

by Joseph R. Conerty

doi:10.7282/T39C6VC7

ETD doctoral

The author owns the copyright to this work.